You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
IN THE TREATMENT OF SEVERELY DISTURBED ADOLESCENTS I HAVE BEEN struck time and again by a simple but critical observation, and it is one which I believe to be central to the theme of adolescent sexuality and the body/mind continuum. That observation is: in whichever way the seriously disturbed adolescent tries to alter his body or its image, it is never right for him or her. There is a constant and urgent need to seek answers which can never quite be found, except if the person distorts his body and its sexual role or, as Freud (1924) described it, disavows the experience of the external world and how he sees himself in relation to it. When I refer to the distortion of the body and its sexual role, and use the description of "disavowal," I am obviously referring to the perversions and the psychoses, both of which are signs of severe mental disorder and both of which become organized and irreversibly established (irreversible without treatment) during the period of adolescence. It is with this that I want to begin the examination and the understanding of that process or processes which affect the body/mind continuum in adolescence or which damage or destroy the relationship to one's body.
I want first to describe my way of thinking about adolescence and psychopathology during adolescence, so that the clinical material and the meaning I have put to this material will be seen within a specific framework. Physical sexual maturity, that is, the beginning of the period of adolescence, means not only a fundamental change in the person's relationship to his body, but it means that from puberty onward psychopathology requires the availability of the sexually mature body for its expression, that is, for the living out in a predictable and a compelling way of those fantasies which are at the core of the pathology. But,